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What is Endoscopic Vessel Harvesting (EVH)?

By Dr. Rajneesh Malhotra in Cardiac Sciences , Cardiac Surgery (CTVS)

Dec 01 , 2016 | 1 min read

Who requires Endoscopic Vessel Harvesting (EVH)?

The patients who are suffering from coronary heart disease as their coronary arteries are not amenable to angioplasty. For most CABG operations, the common conduit for bypassing the coronary artery is still the Great Shapenous Veins harvested from the patients’ own limbs.

How is EVH different from Conventional Procedure?

Conventional Procedure- In the majority of CABG operations, one artery (Left Internal mammary artery) and rest other venous grafts are made. Veins from the legs are taken out (using the conventional method) by making long incisions on the limbs equal to the length of veins required for a bypass graft. For instance, if we need 80cm of veins for four bypasses then the skin of the leg needs to be exposed for 80cm to expose the vein for harvesting.

This can evoke fear in the patient as they are always scared of the long incisions, poor cosmetic appearance and the pain associated with these incisions. These wounds can also take some time to heal. Moreover, wound complications especially in diabetic and obese patients are high and may require a long hospital stay. This method can cause extra cost to the patient if complications occur.

To overcome all these complications associated with the conventional method, a new approach is being adopted across the world. This method is called as Endoscopic Vein Harvesting (EVH) and is performed by our Cardiovascular or Heart Transplant Surgeons.

Benefits of EVH:

It requires a single 1 or 2 cm incision to harvest the whole long length of a vein and any length of the vein can be harvested for CABG by EVH. This reduces the hospital stay, no wound complications, less post-operative pain, and better acceptance by the patient.
The procedure requires the use of minimally invasive instruments and a telescopic camera to internally cut, view and seal side branches and remove the healthy blood vessel with minimum damage to the vessel and it surrounding tissues.
The incision size and minimal dissection of the surrounding tissues of the leg significantly reduce the blood loss.

EVH is being a rapidly adopted as a routine surgical procedure at many centers worldwide for harvesting the leg veins for bypass surgeries.